[A case of nonresectable gastric cancer completely responding to combined chemotherapy according to the mode of progression].

The case was a 82-year-old man with advanced gastric Borrmann 3 cancer on the posterior wall of the cardia. Laparotomy revealed peritoneal dissemination (P3) and liver metastasis (H1). Because of his advanced age and on the basis of local findings, gastrectomy was not performed. In order to treat peritoneal dissemination with two-route chemotherapy, two tubes were placed beneath the cul-de-sac of Douglas and the left subphrenic cavity and at the same time, for the purpose of intra-arterial chemotherapy, one more tube was inserted into the proper hepatic artery. At day 12 and day 25 after the operation, 5-FU (500 mg)-Lipiodol (10 ml) emulsion was infused through the tube inserted into the proper hepatic artery. Within 24 hours following the infusion, hyperthermotherapy was carried out at 42 degrees C for 40 minutes. In addition, two-route chemotherapy with CDDP (100 mg)-STS was given at day 14 and day 28 after the operation. Furthermore, one course of FAM [5-FU (1,500 mg), ADM (30 mg) and MMC (10 mg)] therapy was initiated five weeks after the operation. Although no further chemotherapy was performed thereafter, both gastric endoscopy and CT scanning disclosed complete disappearance of the tumor one year after the operation. This result suggests that combined chemotherapy according to the part of progression is effective for advanced gastric cancer.